doctor tharakan
May 1, 2023

Indications for Ascending Aortic Replacement Surgery When You Need Open Heart Surgery

If you've been diagnosed with an ascending aortic aneurysm, your doctor may have discussed the possibility of aortic replacement surgery to repair the aneurysm. The decision to undergo such a major surgery comes with many questions and concerns, so it is important to be well-informed and knowledgeable in order to make an informed decision.

Ascending aortic replacement surgery is a highly complex procedure, and it is essential that you are aware of what could be involved before making any final decisions. In this article, we'll cover some of the indications for ascending aortic replacement surgery and what you should expect during the process.

ascending aortic replacement surgery

What Is an Ascending Aortic Aneurysm and When Surgery Is Needed

If you or someone you know is diagnosed with an ascending aortic aneurysm, it's natural to be worried. But don't worry-- understanding the symptoms, causes, and treatments of an ascending aortic aneurysm can help you become more informed about this serious condition.

An ascending aortic aneurysm is the enlargement of the ascending portion of the aorta, which carries blood from your heart to your chest, abdomen and legs. If not treated in time, it can cause serious medical complications or even death. Most commonly, this type of aneurysm is caused by conditions such as high blood pressure and atherosclerosis (hardening of the arteries).

Generally speaking, surgery is needed when the diameter of the aorta increases more than 5 cm or when symptoms such as chest pain or shortness of breath start to appear. Other indications for surgery are age-related changes in the aortic walls that could predispose to a major rupture and genetics predisposition for this condition.

It's important to understand that while it's crucial to seek timely treatment should any signs or symptoms occur, proactive medical evaluation might also be necessary for some patients with risk factors in order to prevent serious complications from developing.

Indications for Open Heart Surgery: When an Aortic Aneurysm Requires Replacement

Ascending aortic aneurysm surgery is serious; it requires open heart surgery, where the chest is opened to repair or replace the defective area of the aorta with a graft. So, when is open heart surgery recommended for an ascending aortic aneurysm?

Generally speaking, if your ascending aortic aneurysm has grown to more than 5.5 cm in diameter, you may be a candidate for open heart surgery. Other indications include:

  • When an ascending thoracic aneurysm has grown rapidly over a short period of time
  • A continuous widening of the ascending aorta over time
  • A tear or rupture of the ascending aorta
  • Any combination of these factors increases your risk for rupture.

These are only general guidelines, though your doctor can best determinewhen you need open heart surgery to replace or repair your ascending thoracic aneurysm.

Preparing for Ascending Aortic Replacement Surgery: Preoperative Evaluations and Care

If you've been told that ascending aortic replacement surgery is necessary, you'll want to prepare for the operation. This should include talking to your doctor and understanding what an ascending aortic aneurysm is, what the procedure involves, and what kind of aftercare may be needed. Your doctor will also want to do some preoperative evaluations to determine the best management plan for you.

Preoperative Evaluations

These evaluations can include:

  • physical exam, including basic vital signs (body temperature, respiration rate, etc.), and any tests required based on your medical history.
  • x-ray or angiography to evaluate the size and shape of your thoracic aorta.
  • Doppler ultrasound or echocardiography to measure blood flow in the heart and aorta.
  • lab work such as blood tests, urine analysis or electrocardiograms (EKG), all of which can help determine the best course of treatment for you.

Preoperative Care

Once all evaluations are completed, your doctor will go over the details of the ascending aortic replacement surgery with you. You will also need to discuss any current medications you're taking with your doctor as some may need to be discontinued before surgery as well as any other preoperative care instructions, they may have for you. Doing so will help ensure that everything goes smoothly on the day of surgery and may reduce recovery time afterwards.

The Ascending Aortic Replacement Surgery Procedure: What to Expect

If your doctor has suggested ascending aortic aneurysm surgery, you may be wondering what to expect. While the surgery is complex, knowing the basics can go a long way in easing your anxiety and arming you with all the information you need.

Here is what happens when going through ascending aortic replacement surgery:

  1. You will first be given anesthesia so that you don't feel any discomfort during the procedure.
  2. The surgeon will then make an incision in the chest area to access the heart and other organs in order to replace or repair any damaged or diseased parts of the aorta.
  3. Depending on your individual situation, either a graft or artificial tube can be used to replace any damaged areas of the aorta.
  4. Once all parts have been properly replaced, the incision is closed and sutured shut and then monitored for any post-surgery complications or risks of infection.

The entire procedure generally takes around 4-6 hours to complete, but recovery time will vary from patient to patient depending on their overall condition prior to surgery and other factors such as age and medical history. Talk to your doctor about possible recovery times for you so that you are prepared ahead of time!

Postoperative Care and Recovery After Ascending Aorta Surgery

Once you've had your ascending aortic aneurysm repair surgery, you'll need to take steps to ensure proper postoperative care and recovery. Here are some tips to consider:

Follow your doctor's instructions

It's important to follow your doctor's instructions closely for the best possible postoperative care and recovery. This includes taking all prescribed medications and keeping up with recommended follow-up visits, as well as making all lifestyle changes that have been suggested.

Take it slow

It can be tempting to jump right back into normal activities after major surgery, but it's important to take things slowly. That means no heavy lifting or strenuous exercises for the first few weeks, and don't overdo it with daily activities. A good rule of thumb is to only do what you feel comfortable doing if something feels too hard, then take a break!

Get plenty of rest and nutrition

It's important to get plenty of rest to properly heal after surgery, so make sure you're getting enough sleep at night. And while your body needs extra energy for healing after major surgery, make sure that you're eating healthy foods that are low in salt and fat 

Seek professional help

If any signs of infection occur at any time during or after surgery, be sure to seek medical attention immediately. Additionally, professional help such as physical therapy may be needed if there are any complications related to mobility or movement.

Following these tips will help ensure good postoperative care and recovery from ascending aorta repair surgery so take things slowly and always consult your doctor before resuming any activity after major heart surgery.

Long-Term Follow Up and Monitoring for Patients with an Ascending Aortic Graft

Once your ascending aortic replacement surgery is done, a long-term follow up and monitoring plan will be put in place. Many patients benefit from two to three visits to their doctor each year during the first five years after the procedure.

If an issue is detected during this follow up process, your doctor can assess if any further treatments are necessary. The takeaway? Regular appointments with your healthcare provider are key for maintaining a healthy recovery and preventing problems down the road.


If you are considering ascending aortic replacement surgery, it is important to remember that it is a major surgery. It is a difficult and complex procedure, and your medical team will want to look at all the factors before taking action.

Even after the surgery, you may need to be monitored closely. Other than the postoperative healing period, you may need to adjust your lifestyle to ensure that you keep your aorta and other organs healthy.

Nobody wants to face an open-heart surgery, but if it is needed, it is important to have the support of your family and your medical team. Do not be afraid to ask questions. It is your right to understand what the surgery entails and what the best plan of action is for you.